The past week and a half I have been watching the recent season of the Netflix series 13 Reasons Why, a fictionalized show that follows the grappling of a community following the suicide of a high school sophomore named Hannah Baker. In my practice Center for Love and Sex, the therapists and I also treat Depression, anxiety and other psychiatric issues that clients present to us. What is clearly disturbing is that according to recent studies by the Center for Disease Control more Americans in every age group, from 10 to 75, are committing suicide. While the precipitating event may be different for a middle-aged person than a teen, the fact that the behavior is on the rise should be a concern for every American.

The Suddeness of Suicide

Most people are shocked that someone can seem ostensibly fine or stable one day and end their life the next. The sheer switch and deliberateness is terrifying. Although both Kate Spade’s best friend, brother and husband all knew she was struggling with and being treated for Depression, they were all shocked that she’d end her life. Anthony Bourdain can be seen rejoicing on the set of his CNN show Parts Unknown in Hong Kong with his director and girlfriend Asia Argento and director of cinematography Christopher Doyle. Did something happen in the past 5 days? Or was suicide an option that both Spade and Bourdain had secretly contemplated over a period of years?

Inside the Mind of a Depressed Client

As a psychotherapist who has treated clients with Depression and anxiety for over 20 years, I am trained to listen to what’s between the lines and to ask more direct questions about a person’s intentions regarding suicide.

Unless you’ve suffered from Major Depression, it can be very hard for most people to comprehend the ways a mind can consider death a way out of a pain that seems so interminable. As Andrew Solomon so eloquently wrote in his New Yorker article: Anatomy of Melancholy

“When you are depressed, the past and the future are absorbed entirely by the present, as in the world of a three-year-old. You can neither remember feeling better nor imagine that you will feel better. Being upset, even profoundly upset, is a temporal experience, whereas depression is atemporal. Depression means that you have no point of view.”

How Can You Help?

What can folks do to help stave off this latest wave of suicides? On a micro level, one can ask those that are closest to you who have already been diagnosed with a psychiatric illness whether they have thought about suicide or hurting themselves. It’s important not to avoid the word suicide. In saying his word out loud you’re letting them know you are strong enough to listen to them, no matter what. Then listen.

Be mindful not to give them the reasons they shouldn’t be unhappy by saying: “But you’re so successful!” or “You have so much to live for” . Let them know you’re there for them and that you want to help them find the psychiatric help they need so the pain can be alleviated. With these last two celebrities’ suicides, it’s clear that fame, fortune and family do not prevent people from suffering. Ask your friend or family member if they’d be willing to share these concerns with more people to widen the network of support you can provide.

On a macro level to fighting suicides, one can advocate for more funding for affordable and/or free mental health care for all people. Support the National Alliance on Mental Illness, a non-profit that fights for legislation to expand psychiatric treatment.

Do outreach to your congressperson and senator to pass stricter gun laws since about half of suicides are done by guns. The national map of suicide shows higher levels of suicide in states with the highest gun ownership r

Lastly, if you yourself have had suicidal ideation or the pain, or have thought about active plans on how you would end your life, I encourage you to seek out help right away. Contact National Support Lifeline https://suicidepreventionlifeline.org/ via text or call. 1-800-273-8255. Make one call to a trusted person. There is hope and an alternative to the pain.

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